Oregon Grape
Mahonia aquifolium
TL;DR
Oregon grape is a berberine-containing root used mainly as a topical for psoriasis, where small trials show modest plaque improvement. Oral use carries the same berberine interaction problems without the same evidence.
Ideal For
- People with mild plaque psoriasis wanting a topical adjunct
- Those already using a dermatologist-supervised regimen
Avoid If
- You are pregnant or breastfeeding
- You are giving it to an infant, due to bilirubin displacement risk
- You take drugs metabolised by CYP3A4
- You have liver disease
Frequently Asked Questions
What is Oregon grape?
Does it help psoriasis?
Is it the same as berberine?
What dose is used orally?
Does it interact with medicines?
Who must avoid it?
Overview
Oregon grape (Mahonia aquifolium) contains berberine, berbamine and oxyacanthine. Its best-supported use is topical: 10 percent Mahonia cream applied twice daily has been compared with placebo and with calcipotriol in small psoriasis trials, producing meaningful but smaller improvements than the prescription comparator, with good tolerability. A handful of open-label studies report reduced PASI scores over 12 weeks. Oral use is traditional for digestive complaints and infections, but the human evidence is essentially absent and the berberine content brings the same concerns that apply to berberine itself, including CYP3A4 inhibition and displacement of bilirubin, which is why it is contraindicated in newborns and pregnancy. Treat oral Oregon grape as an inferior, less standardised route to berberine.
How It Works
- Berberine alkaloids inhibit keratinocyte hyperproliferation, relevant to psoriasis plaques
- Inhibits lipoxygenase, reducing inflammatory leukotriene production
- Antimicrobial activity against several bacteria and fungi in vitro
- Berberine inhibits CYP3A4, the source of most interaction risk
Benefits & Outcomes
No linked outcomes yet. Research is ongoing.
Supporting Research5 studies
Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis
Deng S, May BH, Zhang AL +2 more
Topical Mahonia aquifolium showed benefit for psoriasis severity, but the evidence was of low methodological quality.
Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension
Lan J, Zhao Y, Dong F +4 more
Berberine, the main alkaloid in Oregon grape, lowered fasting glucose and HbA1c in pooled trials.
Berberine and barberry (Berberis vulgaris): A clinical review
Imenshahidi M, Hosseinzadeh H
Berberine-containing botanicals inhibit CYP3A4 and are contraindicated in pregnancy and in neonates.
Mahonia aquifolium in patients with psoriasis vulgaris: an intra-individual study
Augustin M, Andrees U, Grimme H +2 more
Mahonia ointment was less effective than dithranol but better tolerated in plaque psoriasis.
A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis
Gulliver WP, Donsky HJ
Most patients using Mahonia ointment for 12 weeks reported improvement in psoriasis severity.
Safety Information
Potential Side Effects
Topical: burning, itching or rash in a minority. Oral: GI upset, nausea. Berberine alkaloids can cause diarrhoea and cramping.
Contraindications
Pregnancy, lactation, neonates and infants; concurrent CYP3A4-dependent medication.
Drug Interactions
- Inhibits CYP3A4, raising levels of statins, ciclosporin and many others
- May add to the glucose-lowering effect of antidiabetic drugs
- Displaces bilirubin from albumin, dangerous in neonates
Pregnancy & Breastfeeding
Pregnancy: Likely unsafe
Breastfeeding: Likely unsafe
Dosage Guidelines
Dosage Used in Studies
Consult healthcare provider
Dosing by Goal
| Goal | Dose | Notes |
|---|---|---|
| Topical | 10% cream applied twice daily to plaques for up to 12 weeks | |
| Oral traditional | Tincture 1-2 mL up to three times daily; not evidence-based | |
| Notes | If the goal is a berberine effect, use standardised berberine HCl instead |
Forms Compared
10% topical cream
The format with actual psoriasis trial data
Root tincture
Traditional oral use; unstandardised alkaloid content
Dried root capsules
No meaningful human evidence for oral use
Food & Timing
Topical use is unaffected by food. Oral tincture is traditionally taken before meals.
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.